Provider Demographics
NPI:1619286549
Name:KOWALSKI, THOMAS WEST (MA LPC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WEST
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4083
Mailing Address - Country:US
Mailing Address - Phone:970-391-1034
Mailing Address - Fax:
Practice Address - Street 1:2756 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-4083
Practice Address - Country:US
Practice Address - Phone:970-391-1034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3729101YP2500X
CO0412491101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool